What is Neurology: A General Neurologist’s Story


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What is Neurology: A General Neurologist's Story

Session 03

In this episode, I talk with a neurologist, Dr. Allison Gray, as we discuss all things about neurology. Is neurology competitive? What is the lifestyle like for a neurologist? Would Allison choose the same specialty again?

Allison is working as a neurologist at a large medical group in a community setting in Colorado. Notice that I follow a standard regimen of questions in these episodes, so you can compare each of the answers to hopefully help enlighten you in choosing your residency.

Listen to this podcast episode with the player above, or keep reading for the highlights and takeaway points.

When Allison knew she wanted to pursue neurology:

  • Getting fascinated by neuroscience
  • Her father being a neuropsychologist

Why community versus academic neurology:

Being drawn more to clinical practice

Types of patients seen by a neurologist:

  • Of all ages: teenagers and up (Pediatric Neurology is a separate specialty with a separate board of accreditation)
  • Fairly healthy and dealing with chronic conditions like migraines
  • People very debilitated by acute neurologic problem like stroke or chronic problem like ALS

A typical day in the life of a neurologist:

  • 8am to 5pm
  • Sees 10 patients a day.
    • This is a lot for neurologists since they have long examinations and they take long histories.
  • Breakdown of her 10 patients:
    • 6 new consults
    • 1 procedure (ex. EMG)
    • 4 follow up visits

What is the lifestyle like for a neurologist?

  • Where she works has an emphasis on creating work-life balance
  • Flexibility in setting her schedule
  • Work-life balance is a challenge for her, being a mom
  • Getting amazing support from staff who let her do physician work because they take as much administrative stuff off her plate as possible
Where she works has an emphasis on creating work-life balance, but she still struggles with balance as a mom.Click To Tweet

Traits that lead to being a good neurologist:

  • Being cerebral (focusing not just on what the problem is and the best treatment, but where the problem is)
  • Interest in solving a puzzle
  • Being able to dive into action quickly (ex. stroke patient)

What makes a competitive applicant for neurology?

  • Getting better grades
  • Getting good board scores makes you more competitive
  • Depends on geography
    • Neurology as a whole is not as competitive as orthopedic surgery or radiology
  • Good shadowing experience
  • Find a way to participate in a neurology elective

Is matching competitive for neurology?

Middle range: It depends on geography and whether you’re going to a very competitive program at a big name institution.

Do you see any bias between MDs and DOs for Neurology?

There is no bias against DOs in neurology that she’s aware of.

[Related episode: MD vs DO: What Are the Differences (and Similarities)?]

What is residency like for neurology?

  • Her residency was volume-heavy and she was seeing many patients
  • Great in-patient heavy doing a lot of in-patient rotations in stroke and acute neurology and Neuro-ICU
  • Out-patient time depends on the academic institution
  • Residency is 4 years (1 year of Internal Medicine and 3 years of Neurology residency)
Neurologists do four years of residency: 1 in internal medicine and then 3 in neurology.Click To Tweet

What she wished she knew going into neurology:

Appreciating that neurology was sad sometimes considering there is still no good treatments for Alzheimer’s, Dementia, ALS, etc. So you see people facing very devastating illnesses that are chronic, debilitating, and even deathly. Neurology is acutely devastating sometimes. It really takes guts to see someone suffering.

However, neurology has a great promise and they’re seeing wonderful new therapies coming out. Compared to 20 years ago, now there’s a huge difference in the way they treat things like MS and genetic disorders.

Neurology is devastating sometimes. It really takes guts to see someone suffering.Click To Tweet

What do you wish primary care providers knew about neurology?

Neurologists are here to help, and they’re happy to help primary care physicians and they can always ask for help.

Specialties she works the closest with as a neurologist:

  • Neurosurgeons
  • Orthopedic surgery
  • Spine clinic
  • Physical therapy

Special opportunities outside of clinical medicine for neurology:

Working with industries to discover new treatments

What Allison likes most about being a neurologist:

  • A wide variety of problems in a day
  • She enjoys helping people and their families in difficult situations.
Being a neurologist allows you to see and treat a wide variety of problems in a day.Click To Tweet

What she likes least about being a neurologist:

The difficulty in not being able to offer someone something to fix a problem

Would she choose neurology if she had to do it all over again?

Yes, Allison thinks the brain is the most fascinating thing in the human body because it defines who we are as people and human beings.

'I think the brain is the most fascinating thing in the human body because it defines who we are as people and human beings.'Click To Tweet

Sub-specialty opportunities for a neurologist:

The future of Neurology:

  • Expanding the knowledge of the nervous system and its treatments
  • A huge number of new therapies coming out

Some pieces of advice for those thinking about entering neurology:

  • Explore both sides of neurology: inpatient and outpatient.
  • Do an elective and go to another institution to see what neurology is like there.
  • Get to see as much as you can because there is a wide variety in neurology, and you don’t want to miss out on what you think it encapsulates just by seeing a piece of it.

Links and Other Resources: